Clinical and Neurological Features with Covid-19 Associated Cavernous Sinus Thrombosis

Abstract

In principle, cavernous sinus thrombosis is a rare disease and can occur as a complication of ear, nose and throat (ENT) infections or facial infections, as well as due to hypercoagulability, however, there is an increase in the frequency of its occurrence in patients who have had COVID -19. Purpose of the study was evaluate the characteristics of clinical and neurological symptoms and laboratory parameters with thrombosis of the cavernous sinus after suffering from COVID -19.Material and research methods. We studied 147 patients with cavernous sinus thrombosis (CS) after coronavirus. The patients were examined at the bases of the Tashkent Medical Academy. The patients were divided into 2 groups: 1) main group-patients with cavernous sinus thrombosis (CS) + type 2 diabetes mellitus (DM), n = 103, 2) control group - patients with TCS without type 2 DM, n = 44. Research results: It was revealed that thrombosis of the cavernous sinus was more common in patients aged 40–70 years (82.1%). Type 2 diabetes was especially common-in 103 (70.1%) patients. Of these, newly diagnosed type 2 diabetes was in 20 (19.4%) patients, more often detected in males-12 (18%) cases. Hypertension was detected in 38 (33.6%) patients, the least common ischemic heart disease was observed - in 10 (9%) and pyelonephritis in 7 (6.1%) patients. With COVID-19, before the appearance of TCS, the following diseases were observed in patients: purulent-necrotic manifestations of the upper respiratory tract (osteonecrosis), phlegmon (orbit, palate, and face), pneumonia, chronic renal failure (CRF), pyelonephritis, central nervous system intoxication, stroke, hyperglycemic ketoacidosis. They may be associated with an inflammatory or prothrombotic state that may cause them. Imaging remains an important part in the management of sick patients, especially when it comes to rare complications, as shown in the example of TCS with patients.

Conclusion: Thus, in patients with Covid-19 and a history of diabetes complicated by cavernous sinus thrombosis, a severe course was more often observed. Signs of cavernous sinus thrombosis appeared on average 21.18±1.66 (P≤0.05) days of illness.